Resources Resources

HIPAA Standard Code Set

hipaa_diag03

Plus about 100 additional codes sets in the X12 formats

Claim Adjustment Reason Code Set

Click here to open the Washington Publishing Company's website for a complete list of the EDI Claim Adjustment Reason Codes used on provider payment vouchers.


Code Set Implications

Code set analysis must be conducted:
  • Local codes are eliminated; translate to standard code set
  • CPT-4 and HCPCS will overlap for physician services.
  • CPT-4 for inpatient procedures now ICD-9-CM
  • Must continuously stay abreast of all changes and communications on medical and non-medical code sets.